Treating Alopecia Areata: Current Practices Versus New Directions

Abstract

Alopecia areata (AA) is non-scarring hair loss resulting from an autoimmune disorder. Severity varies from patchy hair loss that often spontaneously resolves to severe and chronic cases that can progress to total loss of scalp and body hair. Many treatments are available; however, the efficacy of these treatments has not been confirmed, especially in severe cases, and relapse rates are high. First-line treatment often includes corticosteroids such as intralesional or topical steroids for mild cases and systemic steroids or topical immunotherapy with diphenylcyclopropenone or squaric acid dibutylester in severe cases. Minoxidil and bimatoprost may also be recommended, usually in combination with another treatment. Ongoing research and new insights into mechanisms have led to proposals of innovative therapies. New directions include biologics targeting immune response as well as lasers and autologous platelet-rich plasma therapy. Preliminary data are encouraging, and it is hoped this research will translate into new options for the treatment of AA in the near future.

Efficacy of Postbiotics in a PRP-Like Cosmetic Product for the Treatment of Alopecia Area Celsi: A Randomized Double-Blinded Parallel-Group Study

“…Various treatment options are available to clinicians for the management of hair growth [7,26,27] Autologous PRP is a relatively new therapeutic approach for patients suffering from alopecias that has achieved a high degree of compliance among patients [15,28,29]. It differs from other treatments in terms of its mechanism of action, which is based on the actions of the growth factors contained in the formulation, such as platelet-derived growth factor, vascular endothelial growth factor and transforming growth factor, among others, in regulating cell migration, proliferation, remodeling of the extracellular matrix and promotion of endothelial permeability [30].…”

“…First-line treatment for AA includes intralesional corticosteroids for mild cases and topical immunotherapy for extensive disease, but medications such as minoxidil, an antihypertensive vasodilator, and bimatoprost, a prostaglandin analogue, are also used, usually in combination with other treatments [7].…”

Use of adapalene in alopecia areata: Efficacy and safety of mometasone furoate 0.1% cream versus combination of mometasone furoate 0.1% cream and adapalene 0.1% gel in alopecia areata

“…(Gupta, Carviel, & Abramovits, 2017;Kuldeep et al, 2011). Better response to once daily use of M 1 D than twice daily use of M may provide a better patient compliance for treatment.…”

“…And lastly, combination of topical mometasone furoate and adapalene results in a higher satisfaction at the end of the treatment. (Gupta, Carviel, & Abramovits, 2017;Kuldeep et al, 2011). Topical corticosteroids (especially potent ones) are widely used to treat AA but there is little evidence that they promote hair regrowth.…”

Efficacy of subcutaneous injection of platelet‐rich plasma in alopecia: A clinical and histological pilot study on a rat model with a six‐month long‐term follow‐up experience

“…Indeed, alopecia affects a large part of the general population, mainly men since 20 year old because of androgenic cause but also women in case of telogen effluvium or both in case of iatrogenic origin like chemotherapy in oncologic field. In most cases, alopecia progresses to handicapping situations and can lead to cessation of activities …”